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UKK: Respiratory
Category: ePoster Presentation
Code: P - RES - 023

Pneumomediastinum following measles-associated

pneumonia: a case report
Dede Lia Marlia (1) , Fathy Zuandi Pohan(2)

Bayu Asih Public General Hospital Purwakarta West Java(1)

National Cardiovascular Center Harapan Kita, Jakarta(2)

Background: Pneumomedistinum is rarely found as a complication of measles-associated pneumonia in

children. The prevalence is 6-10% among complicated and severe measles cases, even some large studies
do not report any case at all. While pneumomediatinum is detected, close observation and early
intervention is needed to prevent fatal outcome.

Objective: To demonstrate a case of pneumomediastinum as complication of measles-associated

pneumonia.

Case: A 7-month-old boy admitted to the hospital due to severe respiratory distress. He presented with
cough and cold followed by worsen respiratory distress within 1 week. Fever and generalized skin rash
spreading from retroauricular region was preceding the symptoms and there was history of contact with
measles patient. He was well-nourished, cyanosis, somnolence, febrile, and severely distress. Laboratory
examination showed hypoxemia and respiratory acidosis, while chest x-ray revealed bilateral infiltrates.
Diagnosis of measles-associated pneumonia was suggested. Empiric antibiotic was given along with
vitamin A and nutritional support. On the 5th day care in hospital, respiratory distress worsened and
patient was intubated and sent to intensive care unit (ICU). Chest x-ray revealed bilateral
pneumomediastinum. We treated this condition conservatively and pneumodiastinum was then
completely resolved. He was extubated after 5 days and then discharged 3 days later.
Conclusion: Pneumonia associated with measles could result in fatal complications such as respiratory
failure and pneumomediastinum requiring mechanical ventilation and intensive care. Complete resolution
of pneumomediastinum could be achieved with nonsurgical management.

Keyword : measles-associated pneumonia, pneumomediastinum, respiratory failure, mechanical

ventilation, measles